Healthdirect Institutional Pharmacy Services, Inc.

Primary specialty

Long Term Care PharmacyTaxonomy code 3336L0003X

Legal business name

HEALTHDIRECT INSTITUTIONAL PHARMACY SERVICES, INC.

Doing business as

Healthdirect Institutional Pharmacy Services, Inc. #05

Practice address

29 E Main St
Gouverneur, NY 13642-1401

Phone

(315) 287-5002

Fax

(315) 287-7099

NPI assigned

Aug 25, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Stacey Kruth

Title

VP Finance

Phone

(315) 778-7651

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Healthdirect Institutional Pharmacy Services, Inc. #05 Doing business as

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Healthdirect Institutional Pharmacy Services, Inc.

  • Long Term Care Pharmacy
  • Gouverneur, NY
  • NPI 1033539515

  O20140613001647

  Same enrollment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556582400000",
    "number": "1972610699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 E MAIN ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 E MAIN ST",
            "city": "GOUVERNEUR",
            "state": "NY",
            "postal_code": "136421401",
            "telephone_number": "315-287-5002",
            "fax_number": "315-287-7099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHDIRECT INSTITUTIONAL PHARMACY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2019-04-30",
        "status": "A",
        "authorized_official_last_name": "KRUTH",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "315-778-7651"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NY",
            "license": "013565",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00561940",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "3342994",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Healthdirect Institutional Pharmacy Services, Inc. #05",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Healthdirect Institutional Pharmacy Services, Inc. #05",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Teah Lee Griffith
• Payam Hadian, MD
• Christina Harman
• Healthdirect Institutional Pharmacy Services, Inc.
• Healthdirect Institutional Pharmacy Services, Inc.
• Denise Marie Herheim
• Amy Lynne Hillyard
• Danny Len Holmes, LPN
• Natalie May Horne
• Danielle Marie Hough

• Long Term Care Pharmacy in Gouverneur, NY
• Providers in Gouverneur, NY by specialty
• Long Term Care Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.